Sunday, November 02, 2003

"When is this bitch going to die?"

I don't have a link handy and I'm too lazy to hunt for one right now, but I've read about some tragic errors in anesthesiology. It seems that often drugs must be used in tandem, with one to paralyze the patient and another to knock them out.

And some times the knock out drug wears off first. Then the patient is treated the exquisite hell of being cut, sutured or otherwise painfully manipulated without any way to communicate it or avoid it. But they can hear, and they've been known to recite operation-time conversations back to physicians.

Unfortunately this isn't the only way a patient can be rendered helpless but aware. Consider this story of a patient who wasn't dying as expected, and whose attempts to get attention were treated as if they were seizures to be countered with sedatives. In a situation right out of Edgar Allan Poe, she got to listen to the doctors discussing pulling her life support:
I then started spelling the same word in the air, "Don't! Don't! Don't!...."

The doctors decided that the letters I was spelling in the air were repetitive seizure activity and just happened to occur most often when they were in my room discussing killing me...I even took to writing them backwards to make it easy for them to read...

And their response was to sedate me even more....

But, the nursing staff began to believe I was really and truly with them.

One, in particular, starting bringing in a clip board and a broken pen when she talked to me. She would put ink on my fingers, the clip board under my right hand and then ask me yes and no questions in the beginning.

With her I secretly progressed to answering in sentence fragments. However, by doctor's orders she was not allowed to document in my file what she was doing and that I was giving meaningful responses.

But...she did save my inky answer sheets and recorded the questions she asked. She got into a lot of trouble for that.
Look, I understand that this isn't easy. You can cite cases of hundreds of thousands or more being spent on patient with essentially zero quality of life or life expectancy, or even cases where huge sums are spent keeping convicts alive until their execution dates. It doesn't make sense to burden the living with someone who is dead in all but the most technical sense of the term.

And I have relatives who nursed a daughter for 20+ years as she very slowly died from metachromatic leukodystrophy, devolving from a thriving two-year-old to a thin, twisted, helpless, hopeless adult with no sight, hearing, touch or motor control. A 90+ year old relative could die any day now, which might assuage his fear of outliving his money. And at least one slightly younger relative wants the plug pulled if things get to that point. So I know about this stuff firsthand.

And I've concluded that we owe the living the benefit of the doubt, and the burden of proof ought to be on those who would declare them dead.

Yes, this was prompted by the Terry Schiavo situation - the title of the post was spoken by her husband. For much more, see Patterico's Pontifications here and in several other places down the page - this was the source of the blockquote link.

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